The treatment of carpal tunnel syndrome by releasing the transverse carpal ligament has been utilized for over 50 years. During that time, various methods for releasing the transverse carpal ligament have been developed.
Currently, surgical division of the transverse carpal ligament is initiated by making an incision in the skin on the volar aspect of the wrist at about the level of the distal palmar crease. The fat pad underlying the skin in that area is either retracted or excised to expose the transverse carpal ligament between the lateral edge of the palmaris longus tendon and the hook of the hamate bone. Once the ligament is exposed, a small vertical incision is made in the ligament. A grooved probe is then inserted through the incision in the ligament and advanced into the proximal portion of the palm. The tip of a knife is then placed in the groove of the probe and advanced to divide the ligament. The tissues are retracted and the cut edges of the ligaments are visually examined to assure that the appropriate division has been completed. The probe and knife are then reversed to divide the upper portions of the ligament. Inspection is again conducted to confirm proper division of the ligament.
In the prior art, a conventional knife with a blade along one edge was utilized to perform this surgical procedure. The invasiveness of the procedure required lengthy post-operative recuperation for the hand. Typically, it was necessary to elevate the hand for 24 hours, with the application of ice to the operative site for the first 6-8 hours. Use of the hand was to be avoided for 5-7 days, and active flexion exercises were prescribed 10 times 4 times daily. Preferably, no squeezing or gripping with the hand were to be attempted for a month. In addition, a sling to support the arm for 3-4 weeks was preferred in the prior art.